title: Gastrointestinal ostomies and sexual outcomes: a comparison of colorectal cancer patients by ostomy status.
abstract: OBJECTIVE
  Research examining effects of ostomy use on sexual outcomes is limited. Patients with colorectal cancer were compared on sexual outcomes and body image based on ostomy status (never, past, and current ostomy). Differences in depression were also examined.
  
  
  METHODS
  Patients were prospectively recruited during clinic visits and by tumor registry mailings. Patients with colorectal cancer (N = 141; 18 past ostomy; 25 current ostomy; and 98 no ostomy history) completed surveys assessing sexual outcomes (medical impact on sexual function, Female Sexual Function Index, International Index of Erectile Function), body image distress (Body Image Scale), and depressive symptoms (Center for Epidemiologic Studies Depression Scale-Short Form). Clinical information was obtained through patient validated self-report measures and medical records.
  
  
  RESULTS
  Most participants reported sexual function in the dysfunctional range using established cut-off scores. In analyses adjusting for demographic and medical covariates and depression, significant group differences were found for ostomy status on impact on sexual function (p < .001), female sexual function (p = .01), and body image (p < .001). The current and past ostomy groups reported worse impact on sexual function than those who never had an ostomy (p < .001); similar differences were found for female sexual function. The current ostomy group reported worse body image distress than those who never had an ostomy (p < .001). No differences were found across the groups for depressive symptoms (p = .33) or male sexual or erectile function (p values ≥ .59).
  
  
  CONCLUSIONS
  Colorectal cancer treatment puts patients at risk for sexual difficulties and some difficulties may be more pronounced for patients with ostomies as part of their treatment. Clinical information and support should be offered.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Dr. Suite 100, Baltimore, MD, 21224, USA, jreese13@jhmi.edu.
authors.forename: J B
authors.initials: JB
authors.lastname: Reese
authors.forename: P H
authors.initials: PH
authors.lastname: Finan
authors.forename: J A
authors.initials: JA
authors.lastname: Haythornthwaite
authors.forename: M
authors.initials: M
authors.lastname: Kadan
authors.forename: K R
authors.initials: KR
authors.lastname: Regan
authors.forename: J M
authors.initials: JM
authors.lastname: Herman
authors.forename: J
authors.initials: J
authors.lastname: Efron
authors.forename: L A
authors.initials: LA
authors.lastname: Diaz
authors.forename: N S
authors.initials: NS
authors.lastname: Azad
mesh_terms: D000223:Adaptation, Psychological; D001828:Body Image; D015179:Colorectal Neoplasms / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D003863:Depression / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010030:Ostomy / Q000379:methods* / Q000523:psychology*; D011788:Quality of Life; D012725:Sexual Behavior / Q000502:physiology* / Q000523:psychology*; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology* / Q000523:psychology; D012917:Social Adjustment; D011795:Surveys and Questionnaires